Abstract
The World Health Organization has identified surveillance as a key objective in the containment of antimicrobial resistance. Local antimicrobial resistance surveillance data are used to generate antibiograms to monitor resistance patterns and inform clinicians in the selection of the appropriate empiric treatment when culture results are pending, or if laboratory diagnosis is unavailable. However, producing robust bacteriology data is challenging for Pacific Island Countries and Territories with limited microbiology laboratory capacity. The aim of this study is to describe pathogen occurrence and antibiotic resistance in specimens cultured at the main referral hospital in Vanuatu. We reviewed specimen culture results for the period from January 1, 2017 to December 31, 2019. Demographic and clinical data were extracted from printed and electronic registers and described and analysed. A total of 5816 specimens were cultured, of which 21% were culture positive. Staphylococcus aureus was the predominant pathogen overall (41%), and 3% of the isolates were the methicillin-resistant Staphylococcus aureus. Escherichia coli and Klebsiella pneumoniae were the most frequently isolated gram-negative pathogens, of which 14% and 26% were extended-spectrum β-lactamase-producing, respectively. Our results suggest there is a need for other Pacific Island Countries and Territories to conduct similar studies. There are gaps in knowledge about antimicrobial resistance in Pacific Island Countries and Territories. Antibiograms based on reliable data will define and inform local and national actions for containing antimicrobial resistance. There is also a need to establish a regional surveillance network to strengthen national efforts and to link surveillance data for collaborative action against antimicrobial resistance.
Highlights
Addressing and containing antimicrobial resistance (AMR) is a global priority and all countries have committed to developing action plans for this purpose [1]
Pathogens isolated from respiratory tract, cerebrospinal fluid (CSF), stool, body fluids, ear and eye, and genital tract specimens made up 6% (73)
The proportion of culture-positive pathogens was highest in the surgical ward with 36% (451), and this was followed by the outpatient department (OPD) with 18% (217), and the paediatric ward with 17% (213) (Table S1)
Summary
Addressing and containing antimicrobial resistance (AMR) is a global priority and all countries have committed to developing action plans for this purpose [1]. It is predicted that the impact of AMR on low- and lower-middle-income countries (LICs, LMICs) will be severe in terms of the health burden and economic cost of drug-resistant infections and related deaths [2]. Vanuatu and other Pacific Island Countries and Territories (PICTs) face challenges when it comes to combatting AMR. PICTs are in the southwest Pacific Ocean, a region prone to natural disasters. 2020, PICTs have Antibiotics 9, x FOR PEERsmall. Low-income countries have the lowest indicators of socio-economic development and the cultured at Vila Central Hospital (VCH), the main referral hospital in Port Vila, the capital of lowest Human
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